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CONSENT FORM INFLUENZA VACCINE 20172018 Name: (print) Date of Birth: SS#: Street Address: City: State: Zip Code: Phone Number: Vaccine Information Sheet edition date Inactivated Influenza Vaccine
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The date of birth SS refers to the Social Security Administration's records of an individual's birthdate.
All individuals who have a Social Security Number are required to have a date of birth SS on file with the Social Security Administration.
To fill out a date of birth SS, individuals can visit the Social Security Administration's website and update their information online or visit a local Social Security office.
The purpose of a date of birth SS is to accurately maintain records of individuals' birthdates for identification and other purposes.
The date of birth SS typically includes an individual's full name, Social Security Number, and date of birth.
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